APPLICANT'S ABSTRACT: The proposed project will study the spiritual characteristics of African American clients in outpatient alcoholism treatment, and will identify associations between these clients' spiritual beliefs and practices and their treatment retention and outcome. This study will test the hypothesis that clients with higher scores in various dimensions of spirituality (particularly those categorized as "vertical" dimensions) will report superior retention in and outcome from treatment. It will also test the hypothesis that client gender and history of mental health treatment will substantially moderate the relationship between spiritual characteristics and retention and outcome. These hypotheses are based upon the findings of analyses conducted with the African American clients in a large study of substance abuse treatment outcomes (the CSAT Wrap Around Services Impact Study) conducted by the applicant. This study will address many important issues that have not been previously studied. There has been no epidemiologic or outcomes-based research on spirituality in alcohol-abusing African American populations. Furthermore, much of the previous research on spirituality has limited its focus to discrete dimensions of study, and has used cross- sectional designs making it difficult to determine associations with retention or outcomes. The proposed study, however, will assess five dimensions of spirituality, including faith in a higher power, social support, a sense of belonging, infusion of spiritual/moral values, and a purpose in life greater than self. Furthermore, this study will use a prospective cohort design, making it possible to evaluate the relationship between spirituality and treatment retention and outcome. The study expects to sample approximately 260 clients from three outpatient alcoholism treatment programs in urban and quasi-urban areas in southwestern Pennsylvania. Data will be gathered via structured client interviews at two points: upon entry into the treatment program and at three months after entry. The interview instruments are comprised of scales and questions used in WASIS and in NIAAA's Project MATCH, along with a number of statistically valid assessments of various dimensions of spirituality. Given the widely documented emphasis on spirituality and social support in the African American community, it is expected that the proposed project will provide vital information regarding the role of spirituality in the alcoholism treatment of African Americans, leading to the development of more culturally competent care.